Hey there, welcome to Paging Dr. Gupta. This is the show where I get to address your health concerns. My producer, Jennifer, is back with us today. Who do we have up first?

'Hi, Sanjay. We have a 57-year-old listener from Southern California with a question about alcohol and cancer. Here's what he wants to know.

'Hi Dr. Gupta. I'm a fan of your Chasing Life podcast. My name is Ed and what I would like to know is if we drink a lot less alcohol, how much of a difference does that make? And also if we drank for instance non-alcoholic beer, does that avoid the risks of cancer related to alcohol entirely?

Well, this is a great question, Ed. I got to say, first of all, I've cut way back on my drinking as well. I think a lot of people have. We've all heard that drinking is obviously not great for health. And Ed, you might have already heard that studies show alcohol consumption can increase risk of certain types of cancer. But, you know, I realize this is hard for a couple of reasons. First of all, people often drink when they are socializing, when they're networking, when they were celebrating. It is a part of many global cultures. And at the same time, we don't often know how to contextualize how big of a risk factor alcohol is on things like cancer. What I can tell you is this, there is a shifting trend happening in the United States. A 2025 Gallup poll showed only 54% of Americans say they consume alcohol. That's the lowest number in 90 years. And that trend is especially true for younger generations, so the numbers are likely to go up in terms of people who simply aren't drinking. But back to your question, does it have to be all or nothing? What benefits can you get from just drinking less?

We will get into it after a short break.

Okay Ed, back to your question on how much of a difference it could make to decrease cancer risk if you drink less or even become abstinent.

'First of all, let's start with some basic facts about the correlation between alcohol and cancer. What exactly is going on here? In terms of context, alcohol ranks third in terms of preventable causes of cancer in the United States. There is a well-established link between drinking and cancer risk for certain types of cancer, including breast cancer, colorectal, esophageal, liver, mouth, throat, and voice box. Now this increased risk of cancer is associated with all types of alcohol, in case you're curious, and perhaps no surprise, the risk does increase with greater consumption. So those are the basic facts. Next point, how does alcohol actually increase the cancer risk? Well the root cause of cancer are DNA mutations which lead cells to grow out of control and then maybe spread to other parts of the body. What alcohol does is it interferes with cell cycles. It triggers long-term inflammation, and it damages DNA directly. Alcohol can also affect hormone levels, including that of estrogen, which plays a particular role, for example, in breast cancer development. Cells in our mouth can absorb cancer-causing chemicals, carcinogens, more easily when we drink alcohol. So there's plenty of evidence in terms of the impact of alcohol on certain types of cancers, and even more and more information about the mechanisms that make it so. But the question is, can quitting or cutting back bring it down?

'Now the headline is, studies show that cutting back on alcohol, going dry, can decrease the risk of cancer. But it might take a while. Let's begin with liver cancer, for example. There was a study out of Sweden which found that if drinkers don't drink any alcohol, their risk of liver cancer goes down about 6-7% every year. So the researchers estimated that it would take about 23 years of abstinence for a former drinker's risk of liver cancer to decline to the level of a never drinker. I do just wanna say that there is a fair amount of uncertainty with these numbers. So think of these more as ballpark ranges. It obviously varies individual to individual. When it comes to head and neck cancer, researchers found that the increased risk of cancer of the larynx and throat caused by alcohol can be reversed. Five years after abstaining from alcohol, the risk for those cancers fell around 15%. It would take more than 35 years to reach the same level of risk as a non-drinker. For esophageal cancer, they found that like what the other cancers mentioned, the increased risk of esophagial cancer is reversible by quitting, but it would about 16 years to eliminate the extra risk produced by drinking. But quitting does produce significant short-term benefits. The research found that half of the risk reduction I just mentioned happened in the first five years. Now again, something to keep in mind the researchers from the studies I just mentioned, they say that these conclusions are not definitive and there are still questions that remain about how alcohol associated cancer risk might play out over time.

'So look, if you play by the book, you shouldn't drink any alcohol because any amount can increase your risk of cancer. We know that. But you know, we realize for many people, especially in social situations, that may not be desirable. If you're going to drink, it should be done in moderation and not frequently. According to the CDC, moderate drinking is two drinks or less per day for men, one drink or less for women, and again, keep in mind, around half the country simply isn't drinking at all. Alternatives to alcohol, like mocktails, have become much more widely available, and they may help with cutting back. And Ed, you mentioned non-alcoholic beer. That is a good alternative. Because it helps you cut back and avoid alcohol, and that's especially good for social gatherings where everyone has a drink in their hand and you also want that celebratory feeling. One thing I will say though about mocktails and even non-alcoholic beer, many times they have a lot of added sugar and they may have other unhealthy ingredients. So while they may be better for you than a real cocktail, they may still carry some problems. So water, even a sparkling water, flavored water, perhaps is a better choice.

Okay, Ed, I hope that helps. I hope you're able to use that information to make healthier choices. I get it. As I said, I cut way back on alcohol. I drink very, very occasionally nowadays, and I think that's becoming increasingly the norm. If you're not ready to cut back entirely, do refer to those CDC guidelines on moderate drinking. Again, up to two drinks per day for men, one drink per day for women, for a lot of people even that is a lot.

Alright, Ed, thanks for calling in. We're gonna take a quick break here, but when we come back, have you thought about replacing plastic with silicon? What's the difference? We'll get into it after the break.

And we are back with paging Dr. Gupta. Okay, Jennifer.

Who's next?

Alright, our next question comes from Melissa, who has a great question about plastic versus silicone.

Hi, Dr. Sanjay. I know you had several episodes regarding plastic and that an alternative to using plastic is silicone. Silicone containers, silicone spoons, silicone straws, just different areas of silicone but I don't know what silicone is made of. It looks like it's plastic but I'm not quite sure. Is silicone the better alternative to plastic and in between plastic and metal?

Okay, Melissa, first of all, thank you for listening to the podcast. I'm really glad that our show makes you at least think about these things and maybe reconsider the materials you use in your daily life and pay more attention to your health. Your question is really important because we live in a plastic era. It is in everything, including our food supply, the packaging it comes in, our homes, our furniture, our clothing. It's even in personal care products and medical supplies. There's no question plastic can make our lives easier in so many ways, but microplastics and nanoplastics, everyone should pay attention to this. They have made their way into our bodies, into our brains, our reproductive organs, our cardiovascular system. So yeah, considering alternatives to plastic is essential, maybe even urgent.

Let's talk about silicon for a second. What's it made of? Silica is the main ingredient of silicone. It's a compound naturally found in rocks. Silicone itself is not a natural product. Let me repeat that, silicone itself is not an natural product. What happens is the silica undergoes a pretty complicated chemical process to be turned into silicone. Now silicone is more expensive than plastic because the process we're talking about is long and costs more to make. So what is the fundamental difference then between silicone and plastic?

The main thing with plastic is that it's fundamentally not a stable material. Tiny bits of it break off and enter the environment and your food. That's what we're talking about with microplastics and nanoplastics. That can happen, for example, when plastic is heated in a dishwasher or microwave, or if it comes into contact with chemicals that break it down like acid in foods. Even if it's subjected to tiny cuts and abrasive agents like a scratchy sponge, all those things can break off the plastic. While it's not completely standardized, microplastics are considered to be fragments five millimeters and smaller. Nanoplastics are even tinier, one micrometer and smaller, that's one millionth of a meter, all the way down to one billionth of meter. They cannot be seen by the human eye.

There was new research from the National Institute of Standards and Technology, which found plastic items release more nanoplastics in water as the water is getting hotter. And another study found that a square centimeter of a plastic container released more than four million microplastic particles and more than 21 billion nanoplastic particles after being heated in a microwave for just three minutes. Just think about that for a second.

Now, a study in 2024 that got a lot of attention has linked microplastics with direct harm to human health. People with microplastics or nanoplastics in the arteries of their neck, for example, the carotid arteries, were twice as likely to have a heart attack or a stroke or die from any cause over the next three years as compared to people who had none.

So back to silicone. It is more stable and it is more durable. That's the headline. One study found that when they put silicone in boiled water, there were almost no nanoparticles detected. And because its main ingredient is inert, that means it doesn't interact with other chemicals, like acids from foods. So putting food in a silicone container is probably safer than a plastic one if you look at those particular issues alone. Is it a better alternative to plastic? Well, it lasts longer than plastic, so we end up replacing our items less frequently and that cuts down on plastic in the environment. So for that reason alone, it helps decrease the amount of microplastics and nanoplastics out there. Silicone also seems safer in the oven and dishwasher because it can bear higher temperatures than most plastics.

'Does it mean that silicone is perfect? No. There's a few things you should keep in mind. First of all, silicone products are relatively new in the mainstream market, so there are fewer studies done on their safety in terms of long-term health benefits. And if you are using silicone products, they usually have a maximum temperature listed that they can withstand. Pay attention to that. Don't exceed that temperature.

So, Melissa, something a lot of people are thinking about, talking about, I appreciate you raising the question, and I hope our podcast can continue to stimulate your curiosity on all the things that you do in your life, day in and day out.

'And that's a wrap for today's episode. Thanks again to all of you for sending in your health questions. Remember, no question is too big, too small, or too embarrassing. Keep them coming. We might just answer it on our next show. Reach out to us, record a voice memo, email it to pagingdrgupta@cnn.com. That's pagingdrgupta@cnn.com, or give us a call at 470-396-0832 and leave a message. Thanks for listening.